One of Dr. J.’s hep-cat progressive friends from on teh Facebook posted this article from the Atlantic during her wailing, rending of garments and gnashing of teeth as a consequence of the narrow-in-scope Hobby Lobby decision.
The article tries, like so many, tries to blur the lines with regard to when life begins, stating:
What specific point in the reproductive process counts as “conception?”
The plaintiffs in Hobby Lobby define conception as the point when the sperm and egg come together to make a zygote, which is why they object to these birth control methods—they can interfere after an egg has already been fertilized. The American Congress of Obstetricians and Gynecologists, on the other hand, defines conception as the moment when a fertilized egg implants in the uterus. The Supreme Court noted in its decision that federal regulations also define conception this way—“pregnancy encompasses the period of time from implantation to delivery,” one reads.
Let’s take the second part first…The Supreme Court noted in its decision that the federal regulations also define conception [as implantation]. The CFR states c) Fetus means the product of conception from implantation until delivery and f) Pregnancy encompasses the period of time from implantation until delivery.
The regs do not define conception, (at least in 46.102). Period. The author of the Atlantic article is either stupid, dishonest or both.Now lets take the first part, regarding the American Congress of Obstetricians and Gynecologists (ACOG). That was a head scratcher, as ACOG, like the ACC, is a medical organization, and intellectual honesty and scientific rigor are critical elements of developing guidelines for care. That being said, ACOG is a notoriously liberal medical congress. This isn’t the only time that ACOG’s been slippery with regard to the facts. When they talk about the financial burden of contraception on paid employees, in their amicus brief for this case, there are NO CITATIONS, unlike in all of the other sections, to support their argument.
So, Dr. J. googled ACOG and conception and found their ‘Statement on “Personhood” measures.’
The statement is an editorial in opposition to a Mississippi measure to define legal ‘personhood’ in that state as beginning at fertilization:
Like Mississippi’s failed “Personhood Amendment” Proposition 26, these misleading and ambiguously worded “personhood” measures substitute ideology for science and represent a grave threat to women’s health and reproductive rights that, if passed, would have long-term negative outcomes for our patients, their families, and society. Although the individual wording in these proposed measures varies from state to state, they all attempt to give full legal rights to a fertilized egg by defining “personhood” from the moment of fertilization, before conception (ie, pregnancy/ implantation) has occurred. This would have wide-reaching harmful implications for the practice of medicine and on women’s access to contraception, fertility treatments, pregnancy termination, and other essential medical procedures.
These “personhood” proposals, as acknowledged by proponents, would make condoms, natural family planning, and spermicides the only legally allowed forms of birth control. Thus, some of the most effective and reliable forms of contraception, such as oral contraceptives, intrauterine devices (IUDs), and other forms of FDA-approved hormonal contraceptives could be banned in states that adopt “personhood” measures. Women’s very lives would be jeopardized if physicians were prohibited from terminating life-threatening ectopic and molar pregnancies. Women who experience pregnancy loss or other negative pregnancy outcomes could be prosecuted in some cases.
Again, there are two key points in the ACOG statement. The first point is that in this political statement, they say that conception is implantation, and not fertilization. That is their belief, opinion, and position, none of which changes biological and scientific fact. They hold that position because it transforms every agent is capable of preventing implantation into, linguistically speaking, a contraceptive, rather than an abortifacient.
Indeed, prior to the birth of the Lil Medstudent, Mrs. Dr. J.’s OB/GYN discussed postnatal contraception options (as is routine), and he stated to her, “You probably wouldn’t want an IUD based on your values.” He knew, at the time, the mechanism of action of IUDs, and was intellectually honest about it, unlike post-Obamacare ACOG who has gotten Orwellian in its language to describe biology.
They reveal this in their second paragraph when they suggest that barrier methods, spermicides and natural family planning would become the only contraceptives permissible by law, should legal personhood be granted to all human life from conception (fertilization) until natural death. ACOG admits tacitly in this statement that all OCPs can prevent implantation. It is not their only mechanism of action, but it is a potential mechanism of action. Hobby Lobby didn’t even get that memo (or if they did, regular OCPs somehow didn’t bother them as much as IUDs and Plan-B).
As Dr. J. has said in the past, the problem, or perk, depending on your point of view, with OCPs, Plan-B and IUDs is that the patient has no idea IF a new life was created in their womb before an abortifacient mechanism prevents implantation, or if no life was conceived naturally, or due to prevention of fertilization (resulting in the Schrödinger’s Embryo argument ), they just know that they didn’t get pregnant.
As an aside, the Mississippi law largely failed to gain public support because of the legitimate potential conundrum it placed in the management of ectopic pregnancies (a tragic situation where the baby is unsaveable, and the mother’s life is threatened by hemorrhage or potential for hemorrhage) and molar pregnancies (which is a bizarre tumor that formed from a failed fertilization, and is not a person) and other life threatening conditions.
This is where words matter. Dr. J. holds that at fertilization, a new life begins and that is a biological fact. The life may or may not naturally succeed in implantation, successful gestational development, but miscarriages, sadly happen. Dr. J.’s had friends make the point that not all embryos naturally make it to birth in an attempt to justify abortion, but not all children make it to adulthood, does that make infanticide ok, not all adults die of old age, does that make murder OK? No.
But, where does life begin? Our friends from LifeNews cite three papers where the authors describe life beginning at fertilization (conception). Based on the context, it is probably a cited statement in the introductions in those papers, nevertheless, when talking about actual biology, life begins at fertilization. Their point is that you can do a very cursory search of the developmental biology literature and find thousands of papers to cite with similar statements. They also allude to an ethics article in a catholic journal that suggests that the language has been shifting as of late with regard to the definition of conception in the medical literature so as to reframe the argument.
Even Dr. J.’s old med-school embryology text’s 9th edition (the most recent edition) affirms this:
The Developing Human, Moore, – Chapter 2:
As the pronuclei fuse into a single diploid aggregation of chromosomes, the ootid becomes a zygote. The chromosomes in the zygote become arranged on a cleavage spindle in preparation for cleavage of the zygote.
The zygote is genetically unique because half of its chromosomes came from the mother and half from the father. The zygote contains a new combination of chromosomes that is different from that in the cells of either of the parents. This mechanism forms the basis of biparental inheritance and variation of the human species. Meiosis allows independent assortment of maternal and paternal chromosomes among the germ cells . Crossing over of chromosomes, by relocating segments of the maternal and paternal chromosomes, “shuffles” the genes, thereby producing a recombination of genetic material. The embryo’s chromosomal sex is determined at fertilization by the kind of sperm (X or Y) that fertilizes the oocyte. Fertilization by an X-bearing sperm produces a 46, XX zygote, which develops into a female, whereas fertilization by a Y-bearing sperm produces a 46, XY zygote, which develops into a male. – Developing Human, 9th Edition
Moore says that a new life is created without saying a new life is created. Dr. J. recalls it being clearer in the earlier edition, unfortunately he no longer has the text.
In Chapter 3, Moore explains the mechanism of action of Plan-B and IUDs:
Inhibition of ImplantationThe administration of relatively large doses of progestins and/or estrogens (“morning-after pills”) for several days, beginning shortly after unprotected sexual intercourse, usually does not prevent fertilization but often prevents implantation of the blastocyst. A high dose ofdiethylstilbestrol, given daily for 5 to 6 days, may also accelerate passage of the cleaving zygote along the uterine tube. Normally, the endometrium progresses to the luteal phase of the menstrual cycle as the zygote forms, undergoes cleavage, and enters the uterus. The large amount of estrogen disturbs the normal balance between estrogen and progesterone that is necessary for preparation of the endometrium for implantation. An intrauterine device inserted into the uterus through the vagina and cervix usually interferes with implantation by causing a local inflammatory reaction. Some intrauterine devices contain progesterone that is slowly released and interferes with the development of the endometrium so that implantation does not usually occur. – Developing Human, 9th Edition